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Thrush treatment

What is thrush?

Thrush is a common yeast infection caused by an overgrowth of Candida, a fungus that is normally present in small amounts in the vagina and on the skin. When the natural balance of the vaginal environment is disrupted, Candida can multiply and cause the symptoms associated with thrush.

Thrush is not a sexually transmitted infection. It can affect all women, including those who have never been sexually active. It is particularly common during reproductive years, though it can occur at any age. Certain factors can increase the likelihood of an episode, including antibiotic use, hormonal changes, pregnancy, diabetes, and a weakened immune system.

This page focuses on vaginal thrush and treatment options for women. If you are looking for information about thrush in men or oral thrush, further guidance is available from the NHS.

Recognising symptoms

Thrush symptoms vary between individuals, but the most commonly reported are:

• A white, thick, cottage cheese-like vaginal discharge that is typically odourless
• Itching, irritation, or soreness around the vulva and vagina
• Redness or swelling of the vulva
• Stinging or discomfort when urinating
• Discomfort or pain during sex

Treatment options

Several treatment options are available for vaginal thrush in the UK. These broadly fall into three categories.

• Oral antifungal tablets
• Vaginal pessaries
• Topical antifungal creams. 

The most appropriate option depends on your symptoms, medical history, and personal preference, and should be confirmed with a prescriber or pharmacist.

Some antifungal creams can weaken latex condoms and diaphragms, reducing their effectiveness as contraception. Check the product information before use and consider alternative contraception if needed during treatment.

Choosing treatment safely

Thrush treatment is available over the counter for most adults, but for some people medical guidance is needed before starting treatment. The following groups should speak to a GP or pharmacist before starting treatment.

• Pregnancy and trying to conceive: Oral antifungal tablets are not recommended during pregnancy or when trying to conceive. If you are pregnant and experiencing thrush symptoms, speak to your GP or midwife before using any treatment, including over-the-counter options. Vaginal pessaries may be used in pregnancy under medical guidance, but applicators should be avoided.
• Breastfeeding: Some thrush treatments may not be suitable while breastfeeding. Always check with a prescriber or pharmacist before starting treatment.
• Age: Over-the-counter thrush treatments are generally intended for women aged 16 to 60. Anyone outside this age range should seek medical assessment before self-treating.
• Allergies: If you have a known allergy to any antifungal medicine or to any of the ingredients in a thrush treatment, do not use it without speaking to a prescriber or pharmacist first.
• Liver or kidney conditions: Oral antifungal tablets are processed by the liver and may not be suitable for people with liver or kidney conditions. A prescriber will take these factors into account.
• Diabetes: People with diabetes may be more prone to recurrent thrush and may also find that thrush is harder to treat. Medical assessment is recommended.
• Weakened immune system: People who are immunocompromised, including those on immunosuppressant medicines or living with HIV, should seek medical assessment rather than self-treating, as thrush can be more persistent and may require a different treatment approach.
• Medicine interactions: Oral antifungal medicines can interact with several other medicines, including some anticoagulants, certain statins, and other medicines. Always disclose your full medication list to a prescriber or pharmacist before starting treatment.

When to seek medical help

Self-treatment is appropriate for many adults with a straightforward, recurring thrush episode that matches their previous experience. However, medical assessment is recommended in the following circumstances.

• This is your first episode of thrush, or you are not certain the symptoms are due to thrush.
• You are under 16 or over 60.
• You are pregnant or breastfeeding.
• You are experiencing recurrent thrush, defined as four or more episodes within 12 months.
• Symptoms have not improved after completing a course of treatment.
• You notice an unusual smell from vaginal discharge, as this may suggest bacterial vaginosis or another infection rather than thrush.
• There is bleeding, sores, ulcers, or blisters in the vaginal area.
• You have pelvic pain or fever.
• You are concerned about a possible STI or have had a new or recent sexual partner.
• You have a weakened immune system or a condition such as diabetes.

What to expect from treatment

Most people find that thrush symptoms begin to improve within a day or two of starting treatment, with symptoms typically resolving within seven days. However, individual responses vary, and it is not possible to guarantee a specific timeframe or outcome.

If symptoms have not improved within seven days of completing treatment, or if they return shortly after treatment ends, contact your GP or a prescriber. This may indicate that the initial diagnosis was incorrect, that the infection is due to a different Candida species, or that a longer or different course of treatment is needed.

Self-care and reducing recurrence

Alongside any prescribed or over-the-counter treatment, the following measures can help manage symptoms and reduce the likelihood of thrush returning.

• Wash gently with plain, unperfumed water. Avoid soap, shower gel, bubble bath, or douches in the vaginal area, as these can disrupt the natural balance.
• Dry carefully after washing or swimming to avoid moisture that can encourage yeast growth.
• Wear breathable underwear, preferably cotton, and avoid tight-fitting clothing where possible.
• Avoid perfumed products including scented panty liners, wipes, or sprays near the vaginal area.
• Avoid sex if you are experiencing discomfort. Some antifungal creams can also damage latex condoms, so check the product information if you are using barrier contraception.

Do partners need treatment?

Sexual partners do not usually need treatment for thrush unless they have symptoms themselves. Thrush is not classified as a sexually transmitted infection, though in some cases it can be passed between partners. If a partner develops symptoms, they should seek their own medical advice.

How DoktorABC works

DoktorABC UK is a digital health platform that connects patients with independent, UK-registered healthcare professionals through a secure online process.

1. Complete a short medical questionnaire covering your symptoms, medical history, and any relevant medicines.
2. An independent UK-registered prescriber reviews your information and determines whether treatment is clinically appropriate for you.
3. If treatment is considered suitable, a prescription is issued by the UK-registered prescriber in accordance with UK regulations.
4. Your medication is dispensed by a GPhC-registered pharmacy and delivered to your door.

DoktorABC UK does not itself provide medical care, issue prescriptions, or dispense medicines. All clinical decisions are made by the independent prescribing healthcare professional following an individual assessment.

Summary

Thrush is a common and treatable yeast infection caused by an overgrowth of Candida. Treatment options include oral tablets, vaginal pessaries, and topical creams, each suited to different situations. Many people can treat a familiar episode of thrush with over-the-counter products, but medical assessment is important for a first episode, recurrent thrush, symptoms during pregnancy, or any situation where the diagnosis is uncertain. Self-care measures can help reduce the frequency of recurrence. A UK-registered prescriber can assess your individual circumstances and advise on the most appropriate treatment for you.